Skip to main content

Predictors for acute and chronic pouchitis following restorative proctocolectomy for ulcerative colitis

Buy Article:

$43.00 plus tax (Refund Policy)

Abstract Objective 

This study was undertaken to evaluate the cumulative incidence, onset and risk predicting factors for acute and chronic pouchitis. Method 

A consecutive series of patients (n = 210), who underwent restorative proctocolectomy (RPC) and had a minimum follow-up of 12 months was reviewed. The cumulative incidence and onset of pouchitis was determined. Univariate analysis, followed by logistic regression analysis was used to evaluate the association of various demographic, clinical and histopathologic variables with the subsequent development of acute and chronic pouchitis. Results 

A total of 198 patients were included. The mean follow-up was 64 months (range, 12–180). Sixty-four patients (32%) developed pouchitis, 35 acute and 29 chronic. The first episode of pouchitis occurred within the first year in 70% of cases. The presence of backwash ileitis (OR, 2.6; P = 0.015), primary sclerosing cholangitis (PSC; OR, 2; P = 0.018) and the duration of follow-up (OR, 1.1; P = 0.043) were associated with a higher incidence of pouchitis. The duration of follow-up was the only variable associated with acute pouchitis (P = 0.007). The presence of backwash ileitis and PSC were independent risk factors for chronic pouchitis (OR, 5.9; P < 0.001; OR, 2.8; P = 0.001 respectively). Conclusion 

Pouchitis is a heterogeneous disease which tends to occur early after restoration of gastrointestinal continuity. Patients with backwash ileitis and/or PSC are at considerable risk of developing chronic pouchitis. The strong association between backwash ileitis, PSC and chronic pouchitis suggests a common link in their pathogenesis.
No References
No Citations
No Supplementary Data
No Data/Media
No Metrics

Keywords: Ileal pouch-anal anastomosis; pouchitis; restorative proctocolectomy

Document Type: Research Article

Affiliations: 1: Huddersfield Royal Infirmary, Huddersfield 2: St James’s University Hospital, Leeds, 3: Derby Hospitals, Derby, UK 4: Departments of General Surgery, York Hospital, York

Publication date: 2008-10-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more